RESUMEN

There are several lesions which can present as a cyst or pseudocyst of the floor of the mouth with submental repercussion. The aim of this paper is to review the diagnosis methods which can help us to differentiate these lesions such as the surgical peculiarities of every tumour. We are reporting two cases of cystic/pseudocystic lesions of the floor of the mouth with submental repercussion. Both of them were epidermoid cysts. Ranulas, lipomas and lymphangiomas should be considered in the differential diagnosis. Imaging diagnosis, fine needle aspiration and adequate treatment in all of the tumours are reviewed. Both cases were operated via intraoral. They are now free of disease after at least one year. Differential diagnosis of cystic lesions of the floor of the mouth is important because the recommended surgery technique is not exactly the same in all of them. The firmness of the wall of dermoid cysts let their exeresis via intraoral even when they are of a big size. Exeresis of sublingual gland is recommended by most authors to treat ranulas, although it is followed by an important percentage of morbidity.

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Pretendemos revisar los métodos diagnósticos que pueden ayudamos a diferenciar las lesiones quísticas de suelo de boca con afectación submentoniana, así como las peculiaridades de la técnica quirúrgica indicada en cada una de ellas.Presentamos dos casos que fueron diagnosticados de quistes epidermopides. En el diagnóstico diferencial deben ser considerados las ránulas, los lipomas y los linfangiomas. Se revisan el diagnóstico por la imágen, la punción-aspiración con aguja fina y el tratamiento de cada tumor. Ambos casos fueron intervenidos mediante un abordaje intraoral. Actualmente se encuentran libres de enfermedad después de al menos un año. El diagnóstico diferencial de las lesiones quísticas del suelo de la boca es importante porque la técnica quirúrgica recomendada no es exactamente la misma en todas ellas. La firmeza de la pared de los quistes dermoides permite su exéresis vía intraoral aún cuando presenten un gran tamaño. Para el tratamiento de las ránulas la mayoría de autores recomienda la exéresis de la glándula sublingual, a pesar de la morbilidad de dicha técnica

There are several lesions which can present as a cyst or pseudocyst of the floor of the mouth with submental repercussion. The aim of this paper is to review the diagnosis methods which can help us to differentiate these lesions such as the surgical peculiarities of every tumour. We are reporting two cases of cystic/pseudocystic lesions ofthe floor of the mouth with submental repercussion. Both of them were epidermoid cysts. Ranulas, lipomas and lymphangiomas should be considered in the differential diagnosis. Imaging diagnosis, fine needle aspiration and adequate treatment in all of the tumours are reviewed. Both cases were operated via intraoral. They are now free of disease after at least one year. Differential diagnosis of cystic lesions of the floor of the mouth is important because the recommended surgery technique is not exactly the same in all of them. The firmness of the wall of dermoid cysts let their exeresis via intraoral even when they are of a big size. Exeresis of sublingual gland is recommended by most authors to treat ranulas, although it is followed by an important percentage of morbidity

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Simultaneous bilateral facial paralisis (SBFP) occurs in 0.3-2% of all facial paralisis. We report a case of SBFP in association with Lyme disease. A review of literature about SBFP is made, studing specially the one caused by Borrelia burgdorferi. We present a diagnostic guideline of SBFP. Suspect diagnosis of Lyme disease is based on clinical and epidemiological criteria. Culture isolation of this bacteria is difficult, therefore serologic testing is required. Neuroborreliosis treatment is intravenous Ceftriaxone or Cefotaxime. Oral Doxycycline is useful in the treatment of neuritis without central nervous system involvement.

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La parálisis facial periférica bilateral simultánea (PFBS) representa entre el 0,3 y el 2 por ciento de todas las parálisis faciales periféricas. Presentamos un caso de PFBS secundaria a enfermedad de Lyme. Se hace una revisión de la literatura en torno a las posibles causas de PFPS haciendo especial hincapié en el estudio de la provocada por la Borrelia burgdorferi. Se expone un protocolo diagnóstico de la PFBS. El diagnóstico de sospecha de enfermedad de Lyme se basa en criterios clínicos y epidemiológicos. El aislamiento del germen mediante cultivo es difícil, por lo que se recurre a la serología. El tratamiento de la neuroborreliosis es la Ceftriaxona o la Cefotaxima por vía parenteral. La Doxiciclina vía oral se ha mostrado eficaz en el tratamiento de neuritis sin afectación del sistema nervioso central (AU)

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Fifteen cases of nasosinusal inverted papilloma treated in our department from 1994 to 2000 are reported. The most frequent initial symptom was unilateral nasal obstruction. Some others symptoms were rhinorrea, facial pain and self limited epistaxis. The most frequent surgical procedure performed was the paralateral rhinotomy with medial maxillectomy. The median average for the follow up was 28 months, being diagnosed one recurrence. The paralateral rhinotomy with a medial maxillectomy, under functional endoscopic nasosinusal techniques are being more and more used, decreasing the indications of open techniques.

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Presentamos un estudio retrospectivo de 15 casos diagnosticados de papiloma invertido nasosinusal, tratados en nuestro servicio entre 1994 y 2000. La forma de inicio más frecuente fue la obstrucción nasal unilateral. Otra sintomatología asociada fue rinorrea, algias faciales y epitaxis autolimitadas. El tratamiento quirúrgico más frecuente realizado fue la rinotomía paralateronasal con maxilectomía media. En el control posoperatorio (de 28 meses de media) se observó una recidiva sólo en un paciente. La rinotomía paralateronasal con maxilectomía media con ayuda del microscopio óptico, es considerado el tratamiento de elección. No obstante, la incorporación de la endoscopia y la destreza en su manejo, van limitando las indicaciones de cirugía abierta (AU)

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A retrospective series of 76 pedicled pectoralis major musculocutaneus flaps is presented. We used this technique in reconstruction after head and neck tumours resections and in complications of oncological surgery such as pharyngostomes or orostomes. Most of these flaps were used in reconstruction of oral cavity and in postradiotherapy salvaje surgery cases. We also analyse the presence of complications at the donor and receiver sites and its correlation with different parameters like protein levels, haemoglobin, administration of radiotherapy and its dose, previous quimiotherapy and the influence of systemic diseases.

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Se revisa retrospectivamente una serie consecutiva de 76 colgajos pediculados de músculo pectoral mayor, utilizados en reconstrucción tras resecciones de tumores de cabeza y cuello; aunque también se han incluido algunas reconstrucciones por complicaciones postquirúrgicas como faringostomas y orostomas. La mayoría fueron utilizados en reconstrucciones en cavidad oral y tras rescates postradioterapia. Analizamos la presencia de complicaciones en el área donante y receptora y los comparamos con diferentes parámetros como: niveles previos de proteínas, hemoglobina, administración de radioterapia y dosis de la misma, quimioterapia previa, influencia de enfermedades sistémicas en la aparición de complicaciones, etc (AU)

A retrospective series of 76 pedicled pectoralis major musculocutaneus flaps is presented. We used this technique in reconstruction after head and neck tumours resections and in complications of oncological surgery such as pharyngostomes or orostomes. Most of these flaps were used in reconstruction of oral cavity and in postradiotherapy salvaje surgery cases. We also analyse the presence of complications at the donor and receiver sites and its correlation with different parameters like protein levels, haemoglobin, administration of radiotherapy and its dose, previous quimiotherapy and the influence of systemic diseases (AU)

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It is classically been though that radical sinus surgery implies a difficulty for ulterior image diagnosis. The reason is postoperative fibrosis of soft tissue may be shown at TC scan as an occupation of paranasal sinuses. We realized that it does not usually happen. The aim of our study is to find out the appearance of sinuses after radical surgery performed to treat chronic sinusitis, mucocele and sinusal cysts. For so doing we have reviewed symptoms and radiological signs before and after surgery.

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